Major Review Shows E-Cigs Likely Less Harmful Than Cigarettes

Long term health effects of electronic cigarettes still unknown

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Electronic cigarettes are a newer nicotine product, and the medical community is working to understand their effect on users’ health.

In a review of existing research, a British team found that e-cigs were a good option for people trying to quit smoking and that secondhand smoke from them was less harmful than from regular cigarettes.

The authors noted that no long-term research into the effects of e-cig use over time had been conducted.

"Quit smoking as part of a healthy lifestyle."

The review was written by Peter Hajek, PhD, director of the Tobacco Dependence Research Unit at the Wolfson Institute of Preventative Medicine in the UK, and colleagues.

The authors used available research to study the potential effects of electronic cigarette use.

So-called e-cigs were invented in 2003 in Hong Kong and, since 2009, have grown in popularity. The devices work by using a heating element to vaporize a nicotine solution that is often flavored.

Part of the appeal is that the nicotine level can be gradually reduced to help users stop smoking. Nicotine is the addictive chemical in tobacco.

Dr. Hajek and his team used nine research databases to review 286 records on e-cigs, including 99 scientific papers, opinion pieces and other documents.

E-cig use in the United States grew from 0.6 percent of the total population in 2009 to 6.2 percent in 2011, according to the review. In the UK, use went from 2.7 percent of the population in 2010 to 11 percent in 2013.

The reviewers found that 12 to 14 percent of smokers who tried an e-cig became daily users. That low number suggested that e-cigs “in their current form are less satisfactory than cigarettes to most users,” the study authors noted.

The reviewers compared the vapor an e-cig user exhaled with secondhand cigarette smoke. They found that, with an e-cig, “pollutant levels are much lower than from cigarettes and are likely to pose a much lower risk (if any) compared to cigarettes.”

They found that, because e-cigs are a newer product, there hasn’t been a long-term study of effects on the user over time.

The reviewers found that an e-cig delivered 4 to 5 nanograms per milliliter of nicotine, similar to using a nicotine replacement like gum or the patch.

A regular cigarette delivered 10 to 20 nanograms per milliliter of nicotine. The authors noted that more experienced e-cig users got more nicotine during use.

As for using an e-cig to quit smoking, the reviewers found that, generally, e-cigs worked better than gum or the patch in quitting smoking.

The authors cited one paper that found 46 percent of participants using nicotine replacement together with an e-cig successfully quit smoking.

"The evidence we currently have is clear: e-cigarettes should be allowed to compete against conventional cigarettes in the marketplace, ” Dr. Hajek said in a prepared statement. “Health care professionals may advise smokers who are unwilling to cease nicotine use to switch to e-cigarettes. Smokers who have not managed to stop with current treatments may also benefit from switching to e-cigarettes."

The review was published July 30 in the peer-reviewed journal Addiction.

The authors received funding from the National Institute of Drug Abuse, Center for Tobacco Products, National Institute on Drug Abuse and National Cancer Institute.

One author reported travel funding from an e-liquid manufacturer, and another author reported taking part in a study in which the manufacturer provided e-cigs at no cost.

Review Date: 
July 30, 2014
Last Updated:
July 30, 2014